Totally endoscopic pulmonary valve replacement.

IF 1.7 4区医学 Q2 SURGERY Minimally Invasive Therapy & Allied Technologies Pub Date : 2023-12-01 Epub Date: 2023-12-18 DOI:10.1080/13645706.2023.2250422

Takeshi Wada, Ryotaro Nagashima, Kenya Kizu, Tetsushi Takayama, Shinji Miyamoto, Hidenori Sako

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Abstract

A 68-year-old man with a history of valve-sparing aortic root replacement and endoscopic aortic valve replacement was admitted to our hospital with dyspnea. Transthoracic echocardiography revealed severe pulmonary valve regurgitation. The patient had undergone cardiac surgery twice, through median sternotomy and right thoracotomy; therefore, we planned endoscopic pulmonary valve replacement via the left thoracic approach. The patient was placed in a modified right lateral decubitus position and underwent mild hypothermic cardiopulmonary bypass. An on-pump beating-heart technique was used during surgery. The 3D endoscopic system and trocars for surgical instruments were inserted through the left 3rd and 4th intercostal spaces. After incision of the pulmonary artery, the pulmonary cusps were resected. A 27-mm St Jude Medical Epic heart valve was implanted in the intra-annular position. Subsequently, the left atrial appendage was resected. The patient was discharged without complications. To our knowledge, this is the first case of totally endoscopic pulmonary valve replacement.

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全内窥镜肺动脉瓣置换术。

一位68岁的男性，有保留瓣膜的主动脉根部置换术和内镜下主动脉瓣置换术的病史，因呼吸困难入院。经胸超声心动图显示严重的肺动脉瓣反流。患者接受了两次心脏手术，分别是胸骨正中切开术和右胸切开术；因此，我们计划通过左胸入路进行内窥镜肺动脉瓣置换术。患者采用改良的右侧卧位，接受轻度低温心肺转流术。手术过程中使用了泵上心脏跳动技术。通过左侧第3和第4肋间插入3D内窥镜系统和用于外科器械的套管针。肺动脉切开后，切除肺尖。在环内位置植入一个27 mm的圣犹达Epic心脏瓣膜。随后，切除了左心耳。病人出院后没有出现并发症。据我们所知，这是第一例完全内镜下肺动脉瓣置换术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.